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Diagnostic agreement and interobserver concordance with teledermoscopy referrals

Dahlén Gyllencreutz, J.; Paoli, John; Bjellerup, M. LU ; Bucharbajeva, Z.; Gonzalez, Henrik; Nielsen, K. LU ; Sandberg, A. C.; Synnerstad, I.; Terstappen, K. and Wennberg Larkö, A. M. (2017) In Journal of the European Academy of Dermatology and Venereology 31(5). p.898-903
Abstract

Background: Malignant melanoma and non-melanoma skin cancers are among the fastest increasing malignancies in many countries. With the help of new tools, such as teledermoscopy referrals between primary health care and dermatology clinics, the management of these patients could be made more efficient. Objective: To evaluate the diagnostic agreement and interobserver concordance achieved when assessing referrals sent through a mobile teledermoscopic referral system as compared to referrals sent via the current paper-based system without images. Methods: The referral information from 80 teledermoscopy referrals and 77 paper referrals were evaluated by six Swedish dermatologists. They were asked to answer questions about the probable... (More)

Background: Malignant melanoma and non-melanoma skin cancers are among the fastest increasing malignancies in many countries. With the help of new tools, such as teledermoscopy referrals between primary health care and dermatology clinics, the management of these patients could be made more efficient. Objective: To evaluate the diagnostic agreement and interobserver concordance achieved when assessing referrals sent through a mobile teledermoscopic referral system as compared to referrals sent via the current paper-based system without images. Methods: The referral information from 80 teledermoscopy referrals and 77 paper referrals were evaluated by six Swedish dermatologists. They were asked to answer questions about the probable diagnosis, the priority, and a management decision. Results: Teledermoscopy generally resulted in higher diagnostic agreement, better triaging and more malignant tumours being booked directly to surgery. The largest difference between the referral methods was seen for invasive melanomas. Referrals for benign lesions were significantly more often correctly resent to primary health care with teledermoscopy. However, referrals for cases of melanoma in situ were also incorrectly resent five times. The interobserver concordance was moderate with both methods. Conclusion: By adding clinical and dermoscopic images to referrals, the triage process for both benign and dangerous skin tumours can be improved. With teledermoscopy, patients with melanoma especially can receive treatment more swiftly.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Journal of the European Academy of Dermatology and Venereology
volume
31
issue
5
pages
898 - 903
publisher
Elsevier
external identifiers
  • scopus:85014463799
  • wos:000400188900051
ISSN
0926-9959
DOI
10.1111/jdv.14147
language
English
LU publication?
yes
id
6082ee24-30a7-4dd1-8f05-565e1f4838d0
date added to LUP
2017-03-16 08:42:27
date last changed
2018-01-07 11:55:34
@article{6082ee24-30a7-4dd1-8f05-565e1f4838d0,
  abstract     = {<p>Background: Malignant melanoma and non-melanoma skin cancers are among the fastest increasing malignancies in many countries. With the help of new tools, such as teledermoscopy referrals between primary health care and dermatology clinics, the management of these patients could be made more efficient. Objective: To evaluate the diagnostic agreement and interobserver concordance achieved when assessing referrals sent through a mobile teledermoscopic referral system as compared to referrals sent via the current paper-based system without images. Methods: The referral information from 80 teledermoscopy referrals and 77 paper referrals were evaluated by six Swedish dermatologists. They were asked to answer questions about the probable diagnosis, the priority, and a management decision. Results: Teledermoscopy generally resulted in higher diagnostic agreement, better triaging and more malignant tumours being booked directly to surgery. The largest difference between the referral methods was seen for invasive melanomas. Referrals for benign lesions were significantly more often correctly resent to primary health care with teledermoscopy. However, referrals for cases of melanoma in situ were also incorrectly resent five times. The interobserver concordance was moderate with both methods. Conclusion: By adding clinical and dermoscopic images to referrals, the triage process for both benign and dangerous skin tumours can be improved. With teledermoscopy, patients with melanoma especially can receive treatment more swiftly.</p>},
  author       = {Dahlén Gyllencreutz, J. and Paoli, John and Bjellerup, M. and Bucharbajeva, Z. and Gonzalez, Henrik and Nielsen, K. and Sandberg, A. C. and Synnerstad, I. and Terstappen, K. and Wennberg Larkö, A. M.},
  issn         = {0926-9959},
  language     = {eng},
  number       = {5},
  pages        = {898--903},
  publisher    = {Elsevier},
  series       = {Journal of the European Academy of Dermatology and Venereology},
  title        = {Diagnostic agreement and interobserver concordance with teledermoscopy referrals},
  url          = {http://dx.doi.org/10.1111/jdv.14147},
  volume       = {31},
  year         = {2017},
}